| NPI | 1295056992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 003328) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA20151) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2011-11-04 |